Physicians recommend caution, gradual return to exercise after COVID-19 infection

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CONTRIBUTED CONTENT — Regular exercise provides so many benefits to our bodies. It has been shown to prolong and increase the overall quality of life. There are times, however, when we should adjust or modify our exercise routine due to an acute injury or illness. 

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One such example is when we have an infection with the novel coronavirus, otherwise known as COVID-19. While there are general recommendations surrounding exercise when we are currently dealing with a viral infection, certain viruses can cause specific complications, and it is wise to have a plan to follow on how and when to return to exercise. 

Drawing upon my experience as a family and sports medicine specialist with Vista Healthcare, I hope to highlight a few key aspects that can be followed by those who desire to get back to a level of physical activity after COVID-19. This will mainly apply to those who had mild to moderate symptoms and who were not hospitalized. For those desiring to return to exercise after severe disease, such as hospitalization, I would recommend checking in with your primary care or sports medicine provider.

Returning to exercise in any way following a COVID-19 infection should be individualized, and there should be a plan to follow. Here are a couple of recommendations overall. 

Don’t exercise while you still have symptoms 

There are a wide range of symptoms related to COVID-19. Common symptoms include fever, fatigue, body aches, cough and shortness of breath. During the symptomatic phase of the infection, exercise is not encouraged. Getting rest and focusing on recovery from the illness is the best practice. 

In fact, many organizations recommend being symptom-free for at least seven days prior to returning to any type of exercise. In addition to not exercising while you are still experiencing symptoms, you should be off of all medications and other therapies that you are using specifically for symptoms related to the current infection.  

Gradually return to full exercise

Primary care and sports medicine physician Dr. Rhett R. Frei, location and date not specified | Photo courtesy of Vista Healthcare, St. George News

Once symptoms have resolved and you have been seven days symptom-free, gradually return to exercise. This is where a plan really becomes important. It is not recommended to immediately start exercising at the same level of intensity and frequency as prior to the infection, as this could potentially lead to complications from the infection and cause a delay in your return.

There should be a gradual return to your previous fitness level. To get back to where you were prior to the infection will likely take several weeks or even months.  

National organizations such as the American Medical Society for Sports Medicine and the National Strength and Conditioning Association have created general protocols to follow when an athlete is returning to sport or activity following COVID-19. It is recommended, however, to follow these or other protocols under medical supervision, as each plan will have a personalized approach. A few main points to consider include the following: 

  • Limit the percent max heart rate to below 70% during the first couple of weeks following an infection.
  • Remember the mnemonic “FIT,” which stands for frequency, intensity and timing of training. Each of these parameters should also be woven into your plan. For example, for the first week back into training, the frequency of exercise should not be more than three days. The intensity of your training load should be decreased and the time to recover and rest increased. 
  • You may consider the 50/30/20/10 rule, which recommends increasing the training intensity over the course of a four-week period. This rule suggests a 50% reduction in intensity of previous workload during week one, a 30% reduction of previous workload in week two, a 20% reduction in your previous workload in week three and a 10% reduction in week four.

Whatever plan is created for you to follow, it is important to limit the frequency and intensity of exercise initially and then slowly ramp up as tolerated. Rest and recovery become very important at this time, as your body is transitioning from using energy to clear and clean up from an infection to then remodeling the musculoskeletal and cardiovascular systems which are heavily involved in your fitness.  

Be patient

Everyone wants to get back to the activities they love as soon as possible. COVID-19 is a unique infection that does have the potential to create lingering inflammation and fatigue that we need to respect and manage accordingly. 

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One of the primary points I want to make is to be patient. It may take weeks or even months to get back to the fitness level you desire. Rushing the healing process from this type of infection could prolong symptoms and even potentially lead to complications.

While you are progressing forward in your “return to play” protocol, it is important to not experience a return of any of your symptoms during the process. If this occurs, there needs to be an adjustment and further monitoring. When there is any doubt, check in with your health care provider. 

Written by DR. RHETT R. FREI, Vista Healthcare.

• S P O N S O R E D  C O N T E N T • 

Resources

  • Vista Healthcare | Address: 2891 E. Mall Drive, St. George | Telephone: 435-215-0257 | Website.

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